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A Small Step for Olive Oil as HFpEF Treatment

Extra virgin olive oil (EVOO) showed promise as a secondary prevention therapy for heart failure with preserved ejection fraction (HFpEF) in a small uncontrolled study.

Nine study participants with HFpEF and obesity were supplemented with unsaturated fatty acid-rich foods and had their EVOO intake estimated over 12 weeks according to their dietary recall, according to researchers led by Hayley Billingsley, RD, of Virginia Commonwealth University, who presented the data in a poster at this year’s virtual Heart Failure Society of American meeting.

Daily EVOO intake increased from zero at baseline to 23.6 g on average during the study, with greater EVOO consumption accompanied by small but significant improvements in cardiorespiratory fitness on cardiopulmonary exercise testing (CPET).

A statistical model indicated that a 40-g increase in EVOO intake led to increased peak VO2 by just under 2 mL/kg/min, a roughly 6% improvement compared with predicted peak VO2; oxygen uptake efficiency slope also increased by about 0.1.

The nine people in the study had a median age of 56 years. Five were women, and six people were Black.

Dietary recalls were conducted at baseline, 4, 8, and 12 week visits. Participants underwent CPET at baseline and at 12 weeks.

“Further studies are warranted to confirm this finding and establish a basis for testing the effect of EVOO on cardiorespiratory fitness as well as major cardiovascular outcomes and to explore these effects across differing baseline intakes of EVOO,” Billingsley said.

In particular, more work needs to be done with large, rigorous randomized trials, said Tariq Ahmad, MD, MPH, of Yale University School of Medicine, who was not involved with the study.

However, it is biologically plausible that EVOO may be beneficial for HFpEF, commented C. Noel Bairey Merz, MD, of Cedars-Sinai Medical Center in Los Angeles.

For example, olive oil is known to be high in monounsaturated fat, with lower levels of vitamin E, polyphenols, and lipid molecules that may contribute to its anti-inflammatory and antioxidant properties, one group recently cited from the literature.

Some consider HFpEF to be not one disease but several syndromes, some of which may be related to coronary microvascular dysfunction that is linked to inflammation.

If olive oil does help in HFpEF, it would be a source of hope for those with the condition, as patients currently have no treatments proven to improve their clinical outcomes. Results with sacubitril/valsartan (Entresto) have been mixed in this population, and other options have failed outright.

Ahmad noted a range of limitations to the study, such as lack of information on how patients were diagnosed, absence of a control group, and the small sample size.

Another point of caution is the known training effect in exercise studies, Bairey Merz said.

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    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by a grant from the NIH.

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New York City Schools Hit Last Step for Reopening Thursday

Students in hundreds of New York City middle and high schools start in-person classes Thursday, as the system gears up for its first effort at random testing for the new coronavirus.

In the third—and if all goes well—final phase of school reopenings for the nation’s largest district, roughly 1,600 traditional public schools will be open Thursday. On Tuesday, about 870 schools welcomed children in elementary grades, including schools serving children in kindergarten through fifth grade and K-8. Preschool and some special-education students returned to school last week.

“A really extraordinary number of schools will be open and ready to serve, and they’re doing it the right way,” Mayor Bill de Blasio said at a press briefing Wednesday. He said virus testing in schools will start next week.

The mayor has pushed to be one of the few major districts nationwide to offer in-person classes, despite resistance from many teachers and parents concerned that gathering large numbers of people in aging buildings might spread the coronavirus.

An Edward R. Murrow High School student attended remotely from Brooklyn, N.Y., Sept. 21.



Photo:

caitlin ochs/Reuters

About half of the district’s one million students have chosen to study online full time, by city data. Many teachers have gotten permission to teach from home because they have medical conditions or live with someone who does.

The mayor has said schools will close if the share of people tested in New York City who are positive for Covid-19 hits 3% on a seven-day rolling average, and his administration was boosting testing and enforcement of mask wearing and other safety rules in areas seeing increases.

The daily share of people tested in New York City who were positive for Covid-19 hit 3.25% for the first time since June, Mr. de Blasio said Tuesday, just as most public schools began reopening. Despite the uptick, on Wednesday the mayor reported a positivity rate of 1.46% on a seven-day rolling average.

The in-school testing is a result of a deal the city negotiated in September with the teachers union to avert a strike vote. As part of a reopening deal with the union, City Hall promised random monthly testing of 10% to 20% of students and staff showing up in person at each school.

School staff members wore protective masks as they waited for students to arrive for in-person classes at Public School 188 Tuesday.



Photo:

John Minchillo/Associated Press

In correspondence with families, the city described its virus-surveillance program as free, quick and painless.

The city Department of Education asked parents this week to sign consent forms for testing. It said consent isn’t mandatory, but students who don’t have consent forms on file might be required to learn remotely if a school has too few permissions.

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City officials said the test isn’t a long swab, but a short, small one that only goes in the nostril. “We are